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40th Anniversary STFM Conference on Medical Student Education:

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PR1 Engaging Today's Medical Student

Juliann Binienda, PhD; Margit Chadwell, MD; Kathryn M Conniff, MD; Peggy Cyr, MD; Miriam Hoffman, MD; Amanda R. Kost, MD; Suzanne E. Minor, MD; Jacob P. Prunuske, MD, MSPH; Mozella Williams, MD; Vincent WinklerPrins, MD

01/30/14 1:00 PM - 2:00 PM

There can be many challenges to successfully educate today’s medical student. Medical school curricula is crowded, and technology is demanding student attention away from tasks. Medical educators need to understand this current generation of student better and need the training and teaching tools necessary to assist students in navigating through medical school and beyond. This preconference workshop is bringing together medical education experts who will provide an overview of this current generation of medical students. Participants will also be able to self-select from a variety of breakout sessions to discuss mentoring techniques, using media technology in teaching, and efficient clinical teaching methodology. Workshop participants will also be given allotted time to reflect and set goals for direct applicability in their own home institutions.

PR2 FMIG Faculty Advisor Summit

Stanley M. Kozakowski, MD; Ashley E. Bentley, MBA

01/30/14 1:00 PM - 2:00 PM

There are more than 145 Family Medicine Interest Groups (FMIGs) on medical school campuses across the nation, a record-breaking number. FMIG faculty advisors often operate alone on their campuses, supporting the student groups and providing resources for them to flourish. The FMIG Faculty Advisor Summit brings medical school faculty who serve in these roles together and exposes them to new tools and resources that support FMIGs, offers the opportunity to share knowledge of interventions to increase student interest in family medicine, introduces the new Student Interest Influencer Portfolio and its implications, and provides dedicated networking opportunities and dialogue time.

For Student Attendees: My Life And Budget As a Resident (a Panel Discussion)

Melissa D Robinson, MS4; Esther Miriam Johnston, MD, MPH

01/31/14 7:00 AM - 8:00 AM

This informal breakfast discussion, targeted at student attendees, will feature a panel of residents who will describe their life and budget as residents.

P1 Health Policy 101: The Best Medicine for Population Health

Amy Clithero, MBA; Karen Armitage, MD ; Brian G. Solan, MD, MPH

01/31/14 9:45 AM - 10:45 AM

There are numerous published articles on the need for medical student exposure to health policy and advocacy to encourage them to prescribe these "best medicines for population health." Beyond didactic lectures, readings, and skills assignments, we use two immersion experiences to increase both engagement and understanding of the power of good health policy. (1) Students design and implement a community project to identify and address a need of their clinic population and (2) Students visit a health policy organization to interview staff using structured interview questions. Alternatively, students may choose to meet with local newspaper reporters and learn how to write a letter to the editor, pitch a story idea, and hold a successful press interview. Initial data suggest these are valuable learning experiences that may increase involvement in health policy and advocacy in future clinical practice.

P10 Use of YouTube In Clinical and Academic Medicine

Christopher M. Miles, MD; Carol A Hildebrandt, BA; Stephen W Davis, MA

01/31/14 9:45 AM - 10:45 AM

Due to its significant promise as a tool for medical education, there is growing use of social media in this setting. Recently published data have identified the presence of incorrect medical information on the website, A paucity of data exists on the current use of YouTube in education and medical practice. If the use of this medium is high and the presence of misinformation exists, the potential for learning and performing incorrect techniques is a concern. We present the results of a survey of practicing primary care residents and attendings to determine the current level of YouTube use in medicine. Among 84 responding resident and attending physicians, residents used YouTube more than twice as much as attendings (86% versus 37% review a procedure, 69% versus 30% review exam techniques, 52% versus 21% review a therapeutic maneuver) and were more likely to see it as a beneficial tool for education.

P11 Factors Related to Medical Students’ Choices of Primary Care Specialties

Bonnie Vest, PhD; Blake Talbot, MPH; Denise McGuigan, MSEd; Karen Devlin, AS; Linda S. Kahn, PhD; Andrew Symons, MD, MS

01/31/14 9:45 AM - 10:45 AM

Despite the current shortage of primary care physicians and the anticipated increased need, there has been an overall decline in medical student interest in primary care residencies. To better understand the factors that influence medical students’ career choice at our institution, we are conducting focus groups with first–third-year students. Students are asked to discuss their perceptions of primary care and subspecialty fields, particularly elements of the curriculum and experiences during medical school that have shaped their perceptions. To date, 72 students have participated in seven focus groups. Results indicate that students engage in a complex decision-making process incorporating multiple factors that continues throughout their medical school experience. This poster will discuss preliminary results of the focus group sessions, particularly themes that have emerged through qualitative analysis of transcripts.

P12 Development and Pilot Implementation of a Longitudinal Objective Structured Clinical Exam (L-OSCE)

Andrew Symons, MD, MS; Jeanette Figueroa, MD; David Holmes, MD; Denise McGuigan, MSEd; Geoffrey Allen, AS; Pam Coniglio, AA; Karen Zinnerstrom, PhD; Bonnie Vest, PhD

01/31/14 9:45 AM - 10:45 AM

Training and experience in longitudinal care is one of the curricular elements that has been found to increase interest among medical students in primary care careers. Objective Structured Clinical Examination (OSCE) has been used in medical schools for almost 2 decades to test clinical performance and competency skills of medical students. We developed a longitudinal standardized patient case to teach continuity of care, which progresses over the course of the family medicine clerkship. Each student meets the same standardized patient weekly for 4 weeks, simulating a 6-month interval. As the case evolves, issues involving chronic disease management, acute care, hospital care and follow-up, preventive screening, and psychosocial concerns are addressed. We created a mock EHR that is incorporated into these visits to focus on areas of health information management. This poster presents details of the development, content, pilot implementation, and student feedback of this longitudinal OSCE.

P13 Development and Pilot Implementation of a Half-Day Procedural Workshop in the Family Medicine Clerkship

Lorne Campbell, MD; Andrew Symons, MD, MS; David Holmes, MD; Pam Coniglio, AA; William Sticht, BS; Bonnie Vest, PhD; Blake Tablot, MPH

01/31/14 9:45 AM - 10:45 AM

Exposure to procedural skills in a primary care setting has been shown to affect student choice of family medicine as a career. We developed and implemented a 1/2-day procedural workshop in the family medicine clerkship, which covers administering local anesthesia, excisional, punch and shave biopsy, suturing, IUD placement, endometrial biopsy, vaginal delivery, IV placement, trigger point injections, and joint injections. Students completed pre and post evaluations about knowledge and confidence in performing the procedures, as well as potential impact of the workshop on career choice. Student confidence in performing the procedures increased by an average of 57%, 61% of the students indicated that performing procedures would be an important consideration in career choice, and 83% indicated that the workshop positively influenced their perception of family medicine as a potential career choice. This poster describes the development, content, pilot implementation, and student evaluation of the workshop.

P14 The Effectiveness of a Primary Care Track in Fostering Medical Student Interest in Family Medicine

Michelle Wenzel, BS; Leslie A. Patterson, PhD; Karen Hulbert, MD; Douglas J. Bower, MD

01/31/14 9:45 AM - 10:45 AM

Many medical students initially plan on pursuing primary care careers, but their interest declines as they progress through medical school. As such, medical schools are charged with finding innovative ways to sustain initial enthusiasm for primary care. At our medical school, we piloted a Primary Care Track within our Scholarly Pathways Program to connect students to family medicine projects. We offered didactic and interactive sessions and administered a standard evaluation survey with open-ended questions about how the session influenced their interest in pursuing a career in primary care. Using content analysis, we found that sessions were most valuable when they provided networking opportunities, offered assistance to meet Pathway requirements, and discussed current primary care-related topics. Identifying factors related to sustained enthusiasm may be a valuable step in reaching our long-term goal of increasing the primary care workforce by graduating a higher proportion of our medical students into primary care careers.

P15 Development and Implementation of an Interprofessional Health Care Course: Lessons Learned

Charles E. Christianson, MD, ScM

01/31/14 9:45 AM - 10:45 AM

Interprofessional teams are a key element of the patient-centered medical home, and training for team practice should be interprofessional. Our university engaged in a successful 3-year institutional process to develop a 6-week one credit interprofessional health care course for students from eight health professions. An interprofessional team developed and administers the course. It was initially based on a problem-based learning model; as it evolved we have introduced more active learning, role playing, and team communication skills using the TeamSTEPPS approach. Assessment is at the team level, with the team dealing with a clinical case and self-evaluating. Students have generally rated the course highly with the consistent exception of medical students; students note difficulty in applying these team principles to the realities of practice they encounter later.

P16 The Impact of a Student-Run Free Clinic on Reducing Emergency Department Visits

Nick M. Kramer, BS; Jaden Harris, MA; Roger Jamil Zoorob, MD, MPH

01/31/14 9:45 AM - 10:45 AM

There is a well-established gap in access to primary care in the United States, resulting in excess emergency department (ED) visits, higher cost, and a lower quality of care. In 2008, 25% of ambulatory care visits by uninsured individuals were to emergency departments with 12% classified at triage as non-urgent, each costing an estimated seven times higher than a visit to a community health center. The aim of this study is to show the role and potential of the student-run free clinic model in reducing both primary care access disparities and excess burden on emergency services. By surveying patients about their ED usage, access to care, and levels of satisfaction at initial and follow-up visits, we expect to find reduced excess visits to area EDs and patient reported increased access, continuity of care, and satisfaction with their overall level of care.

P17 Implementing an Immunization Improvement Plan in an Underserved Residency Practice

Roger Jamil Zoorob, MD, MPH; Mohammad Sidani, MD, MS; Jaden Harris, MA; Ashley Fields, MD, MPH

01/31/14 9:45 AM - 10:45 AM

Immunization guideline compliance in adults can pose significant challenges, especially in residency training practices serving low health literacy populations. This project seeks to systematically address barriers to compliance by reduction of clinical missed opportunities, improved record keeping, soliciting and addressing patient concerns, and striving for greater patient continuity of care. We have identified areas for improvement and designed our proposed system in accordance with principals of the patient centered medical home model of care, utilizing a team-based approach, improved health information technologies, enhanced provider and patient education and communication techniques, case management and care coordination outreach, and continuous quality improvement feedback methods. We aim to achieve significant progress toward healthy people 2020 goals for immunization within the year by reducing missed opportunies and increasing both provider and patient understanding of vaccines. This plan includes physician and resident team projects, clinical flow improvement, patient education, and outreach.

P18 The Role of Addressing Missed Opportunities in the Patient- Centered Medical Home

Roger Jamil Zoorob, MD, MPH; Mohamad Anis Sidani, MD; Jaden Harris, MA

01/31/14 9:45 AM - 10:45 AM

Various strategies exist for implementing the patient- centered medical home (PCMH) model in practice, but residency and predoctoral training clinics pose additional challenges. The purpose of this project is to describe lessons learned and effective strategies in this process. Fundamental components for success include: programmatic group meetings with wide attendance and representation, clear targets, methods, and personnel responsibilities. Our goals were to: achieve higher compliance with evidence- based guidelines; reduce missed opportunities for indicated screening, prevention, and maintenance care; and optimize chronic disease care. Key strategies are divided into three categories: care coordination, quality improvement, and case management. The highest impact methods found for implementation affecting clinical quality and augmenting limitations of the PCMH in training environments, and indeed influencing trainees in both didactic and experiential modes include: proactive missed opportunities reduction, use of quality improvement methods, use of prevention and disease registries, and targeted outreach.

P19 A Team-Based Approach to Educate Students to Assess Patients’ Health Literacy for Effective Communication

Gail S. Marion, PA-C, PhD; Stephen W Davis, MA; Carol A Hildebrandt, BA; Kathryn P Altizer, MS; Sonia J. S. Crandall, PhD, MS

01/31/14 9:45 AM - 10:45 AM

Health literacy (HL) is a significant health concern in an increasingly complex health system, especially among the underserved. A 5-year grant provides a much needed opportunity for students to effectively care for diverse and underserved patients with chronic disease by highlighting skills for assessing HL in team-based teaching clinics (TBTCs) during a third-year family medicine clerkship. Common Ground (CG) communication training is also assessed. Medical students hone their communication skills in encounters with patients with chronic diseases and limited or low health literacy. Live video-viewing and peer and faculty feedback enhances performance. Students screen for HL and tailor their care in TBTC encounters and use “Teach-back” method to assess patient understanding. Data from more than 20 clerkships suggest the efficacy of this training. Faculty evaluations of clinical skills are highly correlated with students' HL scores. CG scores are also correlated with faculty evaluations and with HL measures.

P2 Drinking From the Fire Hose: A Proactive Approach to Avoiding Medical Student Failure

Ebele Achebe, BA; Louise O'Donnell, PhD; David Henzi, Ed.D; Thomas King, PhD

01/31/14 9:45 AM - 10:45 AM

Studies show that while remediation focuses on helping students pass the exam, they offer no strategies to prevent future failures. The purpose of this study was to help medical students improve their learning efficiency. Participants at risk of academic failure were invited to a series of study skill intervention sessions. The goals of the three sessions were to help students identify their preferred learning style and preview materials effectively, take notes and review, and develop a time management strategy. The participants’ academic performances were compared to the control group's. The control groups were students at risk who had volunteered to participate but did not attend the learning sessions. Preliminary results show a trend of improvement in course grades in participants versus their control counterparts. In addition, three students from the control group have dropped out of medical school, compared to no dropouts in the participant group.

P20 Awareness and Treatment of Uncontrolled Hypertension: Quality of Care in a Family Medicine Resident Clinic

Phillip So, MPH; Steven Lin, MD

01/31/14 9:45 AM - 10:45 AM

The CDC recently declared hypertension as public health enemy number two, yet little is known about the quality of hypertension management in family medicine resident clinics. To investigate resident awareness and treatment of hypertension, a cross-sectional study of 1,011 adult patient encounters was performed in a resident-run, federally qualified health center. More than one in four (26%) patients presented with high blood pressure. Less than half (44%) of all encounters with hypertensive patients resulted in a plan for follow-up or treatment. Of the remaining patients, 30% were documented as hypertensive without a follow-up plan, and 26% were undocumented. When a plan was established, residents chose to delay treatment for further monitoring as often as they prescribed medications. High blood pressure was more likely to be missed during acute care visits compared to routine appointments. Awareness and treatment of hypertension may improve with team-based care, shared ownership of patients, and panel management.

P21 Standardizing Topic Discussions and Promoting Interprofessional Interactions At Seven Geographically Separate Clinical Training Sites

Jonell Sabbe Hudson, PharmD, BCPS; Sherry May Myatt, PharmD; Eli Vinson, PharmD

01/31/14 9:45 AM - 10:45 AM

Ensuring students on family medicine (FM) rotations at geographically separated sites receive comparable educational experiences can be challenging. This poster outlines a process for providing standardization of clinical discussions for FM clerkships offered at seven sites across the state. Standardized discussion topics on diabetes, hypertension, and lipid management were presented via Interactive Video Networking (IVN) emphasizing key points in FMcases. Pharmacy faculty associated with the various practice sites were contacted to provide the clinical discussions over IVN. Color-coded answer cards were used at each site to promote interactions with students at remote sites. To promote interprofessional interactions, pharmacy students were invited to the 2012-2013 academic year discussions but were not required to attend. Evaluations of the clinical discussion in 2011-2012 were positive. Results from 2012-2013 are being tabulated and will be presented. Time of day and desire to teach one-on-one were barriers identified for participation of pharmacy at one site.

P22 IPE: Interprofessional Education, Internalizing Powerful Experiences

Mary Lawhon Triano, MSN, CRNP; Mario Cornacchione, MD; Jennifer M. Joyce, MD

01/31/14 9:45 AM - 10:45 AM

Interprofessional education enables effective collaborative practice, thereby improving health outcomes. The medical education literature, however, provides few descriptions of such an educational model. The interdisciplinary team provides an ideal forum to learn the value of interprofessional education and collaboration. In this poster, we describe our experience with engaging second-year medical students in interdisciplinary team meetings during a 1-week “community experience.” During this week, students participated in interdisciplinary team meetings in the hospice, home health, rehabilitation, or long-term care setting. The focus of these meetings was the care of functionally dependent or terminally ill elders. Participants in the team meetings included physicians, nurses, physical therapists, occupational therapists, social workers, and pastoral counselors. Through reflective practice, students expressed a deeper awareness of the role of the physician as a team member and the value of interprofessional education and collaboration.

P23 Interdisciplinary Education for State Agencies: A Case Study in Connecticut

Kathleen Nurena, MD; Daynna Moriello, MD

01/31/14 9:45 AM - 10:45 AM

Domestic violence is an important public health issue. Addressing community needs requires collaboration. Interdisciplinary education may be a means to foster meaningful collaboration between agencies. Evidence demonstrates an association between domestic violence and animal abuse. Connecticut passed a law mandating cross reporting of suspected child abuse and animal abuse or neglect between the Department of Children and Families (DCF) and the Department of Agriculture, who oversee animal control officers (ACO). The law mandates education for employees in both agencies. Stamford Hospital Family Medicine Residency partnered with DCF to create an educational program for this interdisciplinary audience. The program included medical students and residents, DCF workers, ACO, as well as physicians, prosecutors, and law enforcement officers. We will review reporting statistics to study the impact the program had on awareness and reporting behavior.

P24 Encouraging Community Engagement Among Medical Students: The Early Clinical Experience Honors Project

Betsy Goebel Jones, EdD; Simon Williams, PhD; Patti J Patterson, MD, MPH; Lara W Johnson, MD

01/31/14 9:45 AM - 10:45 AM

The ECE1 Honors Project is an optional activity within the Early Clinical Experience 1 course for which M1 student groups are expected to identify community needs that affect health outcomes, collect data to assess the current status for a particular population, and plan community projects driven by their data. During 2012-2013, groups could submit questions to an Omnibus survey, a single vehicle for data collection for those groups that identified a population of interest within our institution. In all, 22 student groups chose to complete Honors Projects, with topics ranging from medical students’ choices of drinks to participation in rheumatologic support groups. This poster will describe the Honors Project, give examples of student projects, and show resulting plans for community engagement activities.

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Copyright 2018 by Society of Teachers of Family Medicine